On the first day, keynote speaker and 2018 AMP Lifetime Achievement honoree Dr. David Katzelnick described lessons from The COMPASS Study: A system to manage complex patients who have medical and psychiatric comorbidity in primary care and kicked off the meeting by describing lessons learned. First, translating randomized controlled trials into practice requires adaptation. Second, and somewhat conversely, it’s important to keep track of core features of an intervention (without key components, an effective intervention will not work). Third, it is critically important to address social determinants of health. Finally, implementing a new program requires change management, and the real question for implementing health services is this: Can you make it work in the real world?

After the keynote speech, Dr. Anyizhai Annamalai moderated a moving and informative panel on global med-psych. In a gripping account of agency, ethics, trauma, and the benefits of combined and holistic patient care, Dr. Zeina Saliba described some of her experience treating refugees in Greece and emphasized the importance of narratives vs. statistics when conceptualizing this type of work. Dr. Shanna Stryker discussed her work in Cameroon, where she worked in the neuropsychiatric clinic of the Drs. Cairns. Dr. Stryker reminded the audience that one in five patients with catatonia will have a medical cause (and the catatonia won’t improve till the medical cause is addressed). Take-home messages included this quote from Dr. Saliba: “Try to bring the light into the work you are doing, and the world will be better.”

The Residency Fair was packed with training directors, residents, and interested medical students.

Drs. Alison Clay and Tom Heinrich combined to provide a talk on Delirium: Dreams, Distress and Deterrence: Patient and Provider Perspectives. Dr. Clay, a pulmonary-critical care specialist, spoke of her own experiences as a hospitalized patient with delirium (and other experiences) and put her experience in the context of available literature, then Dr. Heinrich discussed various detection, treatment and prevention strategies. Both reminded the audience of the importance of recognizing critical illness and the procedures associated with it as traumatic not only for patients but also their support systems.

The formal presentations of the first day were rounded out by eight outstanding resident vignettes presented by Drs. Olivia Knott, Trygve Dolber, Leopoldine Matialeu, Rachel Gooding, Elizabeth Hoffman, Corey Keeton, Daniel Cho, and Priyadarshina Loganathan. Topics were varied and educational, and longtime AMP member and question-asker Dr. Charlie Schwarz posed challenging and thought-provoking questions to the poised and well-prepared residents.

Saturday, October 13, 2018, dawned bright and early for 5 intrepid AMP members who went for an early morning run before the mentoring session for residents and students, who learned from a panel of faculty members and then rotated “speed-dating” style between tables where other senior members of AMP were available for discussion, while early career physicians attended a separate session on Avoiding Burnout (another important key to and benefit of providing compassionate care to the whole patient).

Med-Psych updates with a theme of pain and compassionate treatment of individuals with acute and chronic pain and substance use disorder were provided by Dr. Steven Prakken, who discussed Pain, Addiction and Buprenorphine, and Dr. Temeia Martin, who described Compassionate Management of Opioids in Sickle Cell Disease During a National Healthcare Epidemic.

During resident and student break-out sessions, Drs. Jennifer Donovan and Joan Anzia gave an outstanding presentation on wellness and addressing burnout. Dr. Donovan’s analogy of tending an orchard, pruning, and maintaining wellness as an intentional activity was a thought-provoking precursor to Dr. Anzia’s message that an important goal is to have admired physician leaders heading discussions about the importance of “a lifelong career in which we feel joy and satisfaction a majority of the time.”

Following lunches and caucuses (which did an outstanding job promoting the mission of AMP and reporting back to the Executive Director – thank you for all you do!) of training directors, early career physicians, and members in training, Dr. Lawson Wulsin moderated a session during which outstanding Innovations in Integrated Care were presented and discussed by Drs. Jeffrey Rado and Angela Rogers (collaborative care for patients with severe mental illness); Dr. Telva Olivares, Ben Lee and Stella King (medicine in psychiatry unit and medicine in psychiatry primary care clinic); Dr. Teresa Long (proactive behavioral response teams) and Dr. Susan Padrino (collaborative care approaches to sickle cell disease).

The day (and meeting) concluded with an interesting presentation by Dr. Jeffrey Fetter on practicing medicine and psychiatry in a correctional setting, with an emphasis on the fact that prison is intended to be punishment by separation from society, not by exclusion from adequate healthcare; and pointing out a significant overlap and comorbidity in behavioral and medical problems among correctional inmates.

Judging from the energy and enthusiasm, founding AMP members in attendance (including Drs. Roger Kathol, Charlie Schwartz and Perry Westerman) were moved to reach out to other founding AMP members to encourage their renewed participation in this organization, which serves as a professional home for people who are passionate about caring for the whole patient.

Awards Presented

Lifetime Achievement Award – David Katzelnick, MD, Professor of Psychiatry, Mayo Clinic College of Medicine and Chair Division of Integrated Behavioral Health Mayo Clinic, for pioneering work in implementation of collaborative care.

Kathol ECP Award – Heather Huang, MD, Faculty, University of Wisconsin School of Medicine and Public Health

In planning for 2019’s Annual Meeting the committee, including co-chairs Drs. Mike Lang and Martha Ward, along with Dr. Mary Beth Alvarez, have secured a larger venue: The Emory Conference Center in Atlanta, Georgia, for October 17-19, 2019. Save the date, and plan to attend a conference focused on “Making it Work in the Real World.”

If you are interested in becoming more active in AMP, please do not hesitate to reach out to the Executive Director at manager@assocmedpsych.org or to Dr. Jane Gagliardi at jane.gagliardi@duke.edu! We are always glad to receive updates about individual, programmatic, educational, clinical, and/or research goings-on and appreciate your updates for communication in the newsletter, as well!